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沙特阿拉伯麦加地区冠状病毒爆发期间儿童急性中毒模式。

Patterns of acute poisoning for children during outbreak of Corona virus in Makkah region Saudi Arabia.

作者信息

Althobaiti Bashayer Mohammed, El-Readi Mahmoud Zaki, Althubiti Mohammad, Alhindi Yosra Zakariyya, Alzahrani Abdullah R, Al-Ghamdi Saeed S, Ayoub Nahla, Refaat Bassem, Eid Safaa Yehia

机构信息

Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.

Saudi Toxicology Society, Umm Al-Qura University, Makkah, Saudi Arabia.

出版信息

Front Pediatr. 2023 Mar 17;11:1087095. doi: 10.3389/fped.2023.1087095. eCollection 2023.

Abstract

BACKGROUND

Poisoning occurs when a person is exposed to an external substance at a too high dose for them. It is possible for young children to be exposed to chemicals. Lungs, the heart, CNS, the digestive tract, and kidneys can be poisoned. In 2004, over 45,000 children and teenagers died from acute poisoning, representing 13% of all accidental poisoning deaths worldwide. Poisoning patterns vary by exposure type, age group, poison type, and dose.

AIM

This study assessed the pattern of acute poisoning with drugs, chemicals, and natural toxins among children (<12 years old). The study was done in Makkah region and registered in the poison control center in Makkah, the forensic chemistry center in Haddah during 2020-2021.

METHODS

A retrospective cohort study was done on 122 children exposed to toxic substances in Makkah. The children were 12 years old and had good health for a maximum of one year. Stratified random sampling was used to divide cases into groups of similar poisons (pharmaceutical products, household products, plant envenomation, and animal envenomation). Then each group got a random samples. The data were analysed with SPSS software.

RESULTS

The mean age of children was 5.2 years, with 59% being boys. The mean temperature, pulse, systolic, diastolic, and respiratory rates were 36.77, 98.29, 109.1, 69.17, and 21.49. The most documented pharmaceutical products (200 mg) were carbamazepine (5 mg), methanol, risperidone (5 mg), propranolol (5 mg), and olanzapine (5 mg). The most common poison forms were tablets (42.6%), syrups (15.6%), capsules (13.9%), and solutions (13.1%). The most common poisoning routes were ingestion (82.8%), dermal (5.7%), injection (4.9%), and inhalation (6.6%). Accidental poisoning was 83%, with a 30-minute lag for 30.3% of children, and most (69.7%) occurred at home. Benzodiazepines were the most commonly used category class drug (18%), with normal pupils and an ECG of 85.2%. Sixty-seven percent had blood tests. Sickness was 9.48, and the positive result was 213.01. The most common presenting symptoms were GIT and neurological (23.8%). 31.1% had mild, moderate, or severe toxicity. Most cases (68%) were complex. 34.4% were intubated, 9.8% had repeated-dose-activated charcoal for enhanced elimination, and 27.8% were on IV fluids. Children with GIT, CVS, respiratory, dermal, and neurological symptoms had a higher percentage of severe toxicity ( < 0.05). Slight toxicity was associated with whole bowel irrigation, intubation for oxygen therapy, N-acetylcysteine or sedation, fluids, and phenytoin ( < 0.05). Complicated cases had a higher mean AST/IUL than non-complicated cases (75.5 vs. 20.08,  < 0.05). The level of toxicity did not correlate with the mean of all lab tests ( > 0.05). The age of the children correlated positively with their systolic BP ( = 0.22,  < 0.01).

CONCLUSION

The results show how important it is to teach the public about poisoning and make rules for tracking and dealing with poisonings in Saudi Arabia.

摘要

背景

当一个人接触到对其而言剂量过高的外部物质时,就会发生中毒。幼儿有可能接触到化学品。肺部、心脏、中枢神经系统、消化道和肾脏都可能中毒。2004年,超过45000名儿童和青少年死于急性中毒,占全球所有意外中毒死亡人数的13%。中毒模式因接触类型、年龄组、毒物类型和剂量而异。

目的

本研究评估了12岁以下儿童药物、化学品和天然毒素急性中毒的模式。该研究在麦加地区进行,并于2020 - 2021年在麦加的毒物控制中心、哈达的法医化学中心登记。

方法

对麦加122名接触有毒物质的儿童进行了一项回顾性队列研究。这些儿童年龄在12岁以下,健康状况良好,最长持续一年。采用分层随机抽样将病例分为类似毒物组(药品、家用产品、植物中毒、动物中毒)。然后每组抽取随机样本。数据用SPSS软件进行分析。

结果

儿童的平均年龄为5.2岁,其中59%为男孩。平均体温、脉搏、收缩压、舒张压和呼吸频率分别为36.77、98.29、109.1、69.17和21.49。记录最多的药品(200毫克)是卡马西平(5毫克)、甲醇、利培酮(5毫克)、普萘洛尔(5毫克)和奥氮平(5毫克)。最常见的毒物形式是片剂(42.6%)、糖浆剂(15.6%)、胶囊(13.9%)和溶液剂(13.1%)。最常见的中毒途径是摄入(82.8%)、皮肤接触(5.7%)、注射(4.9%)和吸入(6.6%)。意外中毒占83%,30.3%的儿童有30分钟的延迟,大多数(69.7%)发生在家中。苯二氮䓬类是最常用的类别药物(18%),瞳孔正常且心电图正常的占85.2%。67%的儿童进行了血液检查。疾病评分为9.48,阳性结果为213.01。最常见的症状是胃肠道和神经系统症状(23.8%)。31.1%有轻度、中度或重度中毒。大多数病例(68%)较为复杂。34.4%进行了插管,9.8%使用了重复剂量活性炭以促进清除,27.8%接受了静脉输液。有胃肠道、心血管、呼吸、皮肤和神经系统症状的儿童重度中毒的比例更高(<0.05)。轻度中毒与全肠道灌洗、吸氧插管、N - 乙酰半胱氨酸或镇静、补液和苯妥英有关(<0.05)。复杂病例的平均谷草转氨酶/国际单位升高于非复杂病例(75.5对20.08,<0.05)。中毒程度与所有实验室检查的平均值无相关性(>0.05)。儿童年龄与收缩压呈正相关(=0.22,<0.01)。

结论

结果表明,在沙特阿拉伯,向公众宣传中毒知识并制定中毒追踪和处理规则非常重要。

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